Appeals Professional
Company: VirtualVocations
Location: Warren
Posted on: November 19, 2024
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Job Description:
A company is looking for an Appeals Professional III to perform
complex work related to medical dispute resolution and appeals.
Key Responsibilities
Review medical records and write clear, concise, and impartial
reconsideration decisions
Make independent decisions based on medical evidence and relevant
regulations
Conduct research to support accurate and well-supported decisions
regarding appeals
Required Qualifications
Associate's degree or 60+ credit hours towards a Bachelor's degree
in healthcare or related field
Three years of experience in medical dispute resolution or Medicare
appeals
Experience in writing or making medical necessity decisions
Clinical experience in Nursing, Physical Therapy, Respiratory
Therapy, or Occupational Therapy
Preferred experience in Medicare
Keywords: VirtualVocations, Toledo , Appeals Professional, Other , Warren, Ohio
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